Supplementary health insurance as a tool for risk-selection in mandatory basic health insurance markets

Paolucci, Francesco, Schut, Erik, Beck, Konstantin, Gress, Stefan, van de Voorde, Carine and Zmora, Irit (2007) Supplementary health insurance as a tool for risk-selection in mandatory basic health insurance markets. Health Economics, Policy and Law, 2 (02). pp. 173-192. ISSN 1744-1331

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Abstract

As the share of supplementary health insurance (SI) in health care finance is likely to grow, SI may become an increasingly attractive tool for riskselection in basic health insurance (BI). In this paper, we develop a conceptual framework to assess the probability that insurers will use SI for favourable riskselection in BI. We apply our framework to five countries in which risk-selection via SI is feasible: Belgium, Germany, Israel, the Netherlands, and Switzerland. For each country, we review the available evidence of SI being used as selection device. We find that the probability that SI is and will be used for risk-selection substantially varies across countries. Finally, we discuss several strategies for policy makers to reduce the chance that SI will be used for risk-selection in BI
markets.

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